Thursday, July 2, 2009

A note from AHA President- Dr. Clyde Yancy

Yesterday, one of many anticipated “AHA Chats” was convened to discuss topical issues in Cardiovascular Disease and Stroke. Health Care Reform was the topic of the day. We were delighted that well over 300 AHA volunteers and advocates called in to participate. As highlighted by Nancy Brown, we are at the cusp of a potentially momentous time in the evolution of health care in this country. The President and Congress are committed to enacting some iteration of health care reform this calendar year. This puts not only Congress but also all stakeholders on an aggressive schedule to review, comment and contribute to the process.

Several topics were reviewed and are worth reiterating now; as an organization, the AHA believes that health care reform that does not result in health care that is as good as or better than the currently available care for most Americans would not represent progress. As an organization we early on staked out the six principles of health care reform that we believe should guide the shape of any program that emerges: everyone in America should have meaningful, affordable health care coverage; preventative benefits are a necessary and important part of health care coverage; all US residents should receive high quality care; health care disparities on the basis of age, gender, race/ethnicity must be eliminated; medical research is an important part of health care reform; and the healthcare workforce should reflect the changing needs of the country.

The AHA Advocacy office and our AHA health policy experts have been working tirelessly to “keep us in the loop”. Both the Senate and the House are developing versions of health care reform. Certain components of health care reform are represented in most, if not all of the pending bills and many of those components are consistent with our AHA policies. These include the elimination of pre-existing medical conditions; the ability to keep already adequate health insurance; extra assistance for low and moderate income families to acquire affordable health insurance and support for small businesses to provide health insurance to all employees. A recently proposed novel strategy creates an “Exchange’ which would represent a portfolio of insurance products from which individuals may select the plan best suited for them and their families. The Exchange would foster competition between the different plans and would create a pool that could be accessed by small and moderate businesses that might not otherwise have the leverage to negotiate coverage rates and benefits. A publicly funded option may be another component of this Exchange and though there is much debate about a ‘public option’, much of that debate needs to be held in abeyance until the details of any public option plan emerge. We anticipate that most proposals are consistently removing lifetime maximal benefits and will insure that once individuals have become sick, health insurance coverage will not disappear.

Clearly there are contentious issues in this debate. The public option being just one of those, employer mandates being another and most recently the possibility of taxing health insurance benefits has emerged. The AHA as a volunteer health organization that has a patient centric approach has not taken a position on any of these issues per se. Our approach has been to follow the process closely and to support the best solutions that achieve our 3 “A”s; affordability, accessibility and adequacy of health care.

The Q & A today was enlightening and brought a personal context to the debate. We heard stories of children with complex heart disease who are underinsured, stroke victims unable to fully participate in rehab programs and victims of heart disease and stroke who are passionate about the incorporation of prevention in any health care reform program. We heard the stories and resonate with the need. The feedback we received today serves to galvanize our efforts even more. Participating in the health care reform process is on the AHA radar screen and will remain an active focus for the AHA and the American Stroke Association in 2009 and beyond as needed.